Has early mortality following single‐unit unrelated cord blood transplantation improved in recent years? A nationwide registry data analysis from 2003 to 2022 in Japan

Unrelated single-unit cord blood transplantation (CBT) is a valuable alternative donor source for patients without matched related or unrelated donors. Although initial concerns included limited cell dose, delayed haematopoietic recovery and higher early mortality, advancements in transplant practices may have led to improved outcomes. However, it remains uncertain whether these improvements extend to the most recent years. We conducted a nationwide, registry-based retrospective study of 15 816 patients who received unrelated single-unit CBT in Japan and analysed across four time periods: 2003-2007, 2008-2012, 2013-2017 and 2018-2022. Overall survival (OS) improved significantly across time periods, with 3-year OS increasing from 38.8% (2003-2007) to 54.4% (2018-2022; p < 0.001). Similarly, 100-day non-relapse mortality declined from 19.6% to 9.5% (p < 0.001). Neutrophil and platelet engraftment rates also rose steadily, reaching 89.6% and 78.0%, respectively, in the most recent period. The most notable improvement in 100-day OS occurred among patients aged ≥60 years. Early mortality within 100 days due to bacterial and fungal infections, graft failure, haemorrhage and graft-versus-host disease (GVHD) significantly decreased over time. This study shows clear and consistent improvements in transplant outcomes, especially in the most recent 5-year period.

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Publication Details

Journal
British Journal of Haematology
Published
2025-08-16
DOI
https://doi.org/10.1111/bjh.70099
Citations
1
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
1.77

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article

Has early mortality following single‐unit unrelated cord blood transplantation improved in recent years? A nationwide registry data analysis from 2003 to 2022 in Japan

Masatsugu Tanaka, Naoyuki Uchida, Masako Toyosaki, Shigesaburo Miyakoshi et al.
1 citations
British Journal of Haematology
Hematopoietic Stem Cell Transplantation
1.77
article

Has early mortality following single‐unit unrelated cord blood transplantation improved in recent years? A nationwide registry data analysis from 2003 to 2022 in Japan

Masatsugu Tanaka, Naoyuki Uchida, Masako Toyosaki, Shigesaburo Miyakoshi, Noriko Doki, Yasufumi Uehara, Yoshiko Atsuta, Fumihiko Ishimaru, Hideki Nakasone, Satoshi Takahashi, Junya Kanda, Fumihiko Kimura, Yasushi Onishi, Masahito Tokunaga, Koji Kato, Hikaru Kobayashi, Kazuya Ishiwata, Takahiro Fukuda, Yasuji Kozai
article en
1 citations

Abstract

Unrelated single-unit cord blood transplantation (CBT) is a valuable alternative donor source for patients without matched related or unrelated donors. Although initial concerns included limited cell dose, delayed haematopoietic recovery and higher early mortality, advancements in transplant practices may have led to improved outcomes. However, it remains uncertain whether these improvements extend to the most recent years. We conducted a nationwide, registry-based retrospective study of 15 816 patients who received unrelated single-unit CBT in Japan and analysed across four time periods: 2003-2007, 2008-2012, 2013-2017 and 2018-2022. Overall survival (OS) improved significantly across time periods, with 3-year OS increasing from 38.8% (2003-2007) to 54.4% (2018-2022; p < 0.001). Similarly, 100-day non-relapse mortality declined from 19.6% to 9.5% (p < 0.001). Neutrophil and platelet engraftment rates also rose steadily, reaching 89.6% and 78.0%, respectively, in the most recent period. The most notable improvement in 100-day OS occurred among patients aged ≥60 years. Early mortality within 100 days due to bacterial and fungal infections, graft failure, haemorrhage and graft-versus-host disease (GVHD) significantly decreased over time. This study shows clear and consistent improvements in transplant outcomes, especially in the most recent 5-year period.

British Journal of HaematologyVol. 207(5)
Tokai University (JP), Jichi Medical University (JP), Tokyo Medical University (JP), Aichi Medical University (JP), Kyoto University (JP), Japanese Red Cross Society, Japan (JP), Kanagawa Prefectural Hospital Organization (JP), Tokyo Metropolitan Komagome Hospital (JP), National Defense Medical College Hospital (JP), Tohoku University Hospital (JP), Kitakyushu Municipal Medical Center (JP), Imamura Hospital (JP), Nagano Red Cross Hospital (JP), Tokyo Metropolitan Institute of Gerontology (JP), Tokyo Metropolitan Tama Medical Center (JP), Tokyo Metropolitan Geriatric Hospital (JP), The Japanese Data Center for Hematopoietic Cell Transplantation (JP), Jichi Medical University Saitama Medical Center (JP), Toranomon Hospital (JP), Kanagawa Cancer Center, Bank of Japan (JP), National Defense Medical College (JP), The University of Tokyo (JP)
Japan Agency for Medical Research and Development
Good health and well-being
Openalex Percentile: Top 13%
Hematopoietic Stem Cell Transplantation
1.77
DOIOpen Access PDFOpenAlex
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